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Histology Department FOR FK & FKG USU STUDENTS ONLY

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Prepared by: LokDonLub


1
URINARY SYSTEM
• Consist of:1,2,3,4
1. A pair of KIDNEYS  glandular component
2. A pair of URETERS
3. An URINARY BLADDER
4. An URETHRA
KIDNEY
• Functions :1,2,3,4
1. Clear blood plasma of metabolic wastes
(creatinine, uric acid, urea)
2. Regulate fluid osmolality & volume
3. Help maintain Acid-Base balance
4. Eliminate drugs, pesticides etc
5. Endocrine functions (renin & erythropoetin)
6. Activating inactive vitamin D to active form ( 1,25
dihydroxy vitamin D3)
MACROSCOPIC STRUCTURE
• Bean shaped with 2 layer of thin-strong conn tissue
capsule:1
– Outer fibrous layer: type I & type III collagen &
occasional fibroblasts
– The inner layer: types I & III collagen & myofibroblasts

• Hillum :
– A concave border, enter point of renal arteries & nerves
– Exit point of renal vein, lymphatic vessels & ureter

• Renal pelvis (expanded upper end of ureter)  2 or


3 major calyces  8-12 smaller- minor calyces (All
surounded by renal sinus which contain adipose
tissue)
2 layer of thin-strong conn
tissue

Expanded
upper end of
ureter
KIDNEYS PARENCHYMA
• Kidneys parenchyma divided into:
1. Cortex
• Outer region, darker & granular appearing
• Subdivided into: cortical labyrinth &
medullary rays
2.Medulla
• Paller & smoother
• Consist of medullary/renal pyramids
Cortical Labyrinth &
Medullary/Renal
Pyramids Medullary Rays
THE CORTEX
• The cortex  Cortical labyrinth & 500 or so
medullary rays:
– The cortical labyrinth: composed of
• The renal corpuscles
• The convoluted tubular portions of the nephron
– Each medullary ray: an extension of the renal
medulla (pars recta of proximal & distal convoluted
& collecting ducts) into cortex  forms the kidney
lobule
THE MEDULLA
• Composed of 10 to 18 renal pyramids  each
constitute a lobe of the kidney

• At the apex of each pyramid perforated by 15


to 20 papillary ducts (of Bellini) at the area
cribrosa

• The renal columns (of Bertin): cortical-like


material in the region of the medulla between
neighboring renal pyramids
MACROSCOPIC STRUCTURE
• Renal lobule : a medullary ray + associated
cortical tissue

• Renal lobe : a medullary/renal pyramid +


associated cortical tissue

• Human kidney : a multilobular kidney


MICROSCOPIC STRUCTURE
• The uriniferous tubule → the functional unit,
consist of:
– The Nephronsecretory portions
– The Collecting Tubule excretory portions

• Each lobe made from uriniferous tubule 


epithelial tubule
NEPHRON
• Each kidney contains 1–1.4 million nephrons2

• Major Divisions:2
1. Renal corpuscle
2. Proximal convoluted tubule  located primarily in cortex
3. Thin & thick segment (loop of Henle)  Descend into
medulla, then ascend back to cortex
4. Distal convoluted tubule

• 3 types of nephrons  base on renal corpuscles location


in cortex1
– Juxtamedullary nephrons: long, thin limbs of Henle’s loop,
– Cortical (subcapsular) nephrons: located just beneath capsule
– Midcortical (intermediate) nephrons: renal corpuscles in
midcortical region
Renal Corpuscle Proximal Convoluted
Tubule
Distal Convoluted
Tubule

Ascending thick
Nephron Loop / Pars
Recta distal tubule
Descending thick Nephron
Loop / Pars Recta Proximal
tubule

THE URINIFEROUS Thin Descending Nephron


TUBULE  NEPHRON Loop
+ COLLECTING
TUBULE
Thin Ascending Nephron
Loop

Collecting Tubule
RENAL LOBE  THE
URINIFEROUS
TUBULE  NEPHRON
TYPES
RENAL CORPUSCLE
• The beginning of a nephron, Ø ±200 µm, differ in
size:1,2
– Near medulla  larger & tubules longer
– Periphery of cortex  smaller & tubules shorter

• Consist of:1,2,3
– The Glomerular Capillaries: fenestrated, large pores (Ø
60-90 nm), lacking diaphragms. The endothelial cell
possess aquaporin-1 channels for rapid passage of water
– The Glomerular - Double-Walled Epithelial Capsule
(Bowman’s Capsule):
• Viceral/Internal Layer  closely envelopes the capillaries 
PODOCYTES
• Parietal Layer  outer surface of capsule  simple squamous
epithelium
VASCULAR POLE :
afferent & efferent
arterioles enter &
leave

URINARY/TUBULAR
POLE :
Region opposite
vascular pole, where
the proximal
convoluted tubule
begins
PODOCYTES
• Modification of viceral
epithelium cells → Speciallized,
large & stellate cells

• Primary processes (wrap


around glomerular capillaries)
 Secondary
processes/pedicles

• The spaces between pedicles 


filtration slits (30–40 nm wide)
with thin slit diaphragms (with
specialized intercellular
junction)
GLOMERULAR FILTRATION
BARRIER formed by:
1. Fenestrated glomerular
endothelium
2. A thick glomerular basal
membrane (~ 0,1 µm)
manufactured by the
podocytes & the endothelial
cells  a selective
macromolecular barrier
which acts as a physical filter
& as a barrier against
negatively charged molecules
3. Filtration slits between
podocyte processes
MESANGIAL CELLS
• Interstitial tissue composed
of:
– Intraglomerular mesangial
cells
– Extraglomerular mesangial
cells

• Stellate cells with long


cytoplasmic processes 
resemble pericytes

• Contractile

• Respond to angiostensin II 
mediate blood flow through
glomerular capillaries
MESANGIAL CELLS FUNCTIONS:1
PROXIMAL TUBULE
• Continous with parietal
Bowman’s capsule
• 2 Region:
– Convoluted portions/pars
convoluta
– Straight portions/pars recta

• CONVOLUTED PORTIONS:
– Most frequently seen in cortex
– Reabsorb 60–65% of water
filtered in renal corpuscle, also
almost all of nutrients, ions,
vitamins & small plasma
proteins
– Single layer of pyramidal cells:
• Acidophilic cytoplasm 
numerous mitochondria
• Prominent microvillus
border/brush border  for
reabsorption
• Not all show nucleus because
large size of cells
PROXIMAL CONVOLUTED TUBULE

A micrograph of the renal cortex allows comparison of the wide,


eosinophilic proximal convoluted tubules with the smaller, less well-
stained distal convoluted tubules. X160. H&E.
PROXIMAL TUBULE
• THE STRAIGHT PORTION:
– or descending thick limb of Henle’s loop
– Shorter & enter the medulla
– Histologically similar to convoluted portion but
brush border shorter at its distal terminus
NEPHRON LOOP/HENLE’S LOOP
• Involved in making urine hypertonic & conserving water

• 3 regions:
– Descending thin limb
– Henle’s loop
– Ascending thin limb

• Composed of a simple epithelia, cuboidal near the cortex, but


squamous deeper in the medulla:
– Type I –IV
– Structure varies according permeability to water, organelle content & tight
junction
– Type I - IV in descending & ascending thin limb
– Type I only in cortical nephrons
– Type II, III, IV in juxtraglomerular nephrons
– Thin descending limb  squamous epithelial cells whose nuclei protrude
slightly into the lumen
Micrograph shows the simple squamous
& cuboidal epithelia of the nephron loop
thin limbs & thick limbs respectively, as
well as the pale columnar cells of the
collecting ducts. X160. Mallory
trichrome.
A micrograph of a medullary
pyramid cut transversely shows
closely packed cross sections of the
many nephron loops' thin
descending limbs (T) and thick
ascending limbs (A), intermingled
with parallel vasa recta capillaries
(C).
DISTAL TUBULE
• Divided into:
1. Straight part (pars recta)  contain
macula densa (pars maculata)
2. Convoluted portions (pars
convoluta)

• STRAIGHT PORTIONS OF DISTAL


TUBULE:
– Or ascending thick limb of Henle’s
loop
– Begins much deeper in the medulla
– Cuboidal epithelium with smaller
cells & few microvilli  more
nuclei seen than in Proximal
tubule
– Lack brush border
– Contain macula densa
MACULA DENSA:1,2
• Group of speciallized
cells in distal tubule
• Taller & narrower
nuclei closer together
& more prominent 
darker appearance
• Communicate with
juxtaglomerular cells at
afferent arteriole
• Consist of :
1. Macula densa
JUXTAGLOMERULAR
2. Extraglomerular mesangial
cells/Lacis cells
APPARATUS
3. Juxtaglomerular cells

• Function: autoregulation
of the glomerular filtration
rate (GFR) & controlling
blood pressure

• Juxtaglomerular Cell:
– Highly modified smooth
muscle in wall of afferent
arteriole • Lacis Cells:
• Same supportive functions as inside
– Contain secretory granule the glomerulus
– Produce renin • Also transmit signals from macula
densa into the glomerulus, affecting
vasoconstriction
DISTAL TUBULE
• Convoluted Portions Of
Distal Tubule:
– Shorter than PCT  fewer
seen
– Lumen wider than PCT
– Cells shorter & lighter
– Nuclear seen in each cell
– No brush border
– Few luminal microvilli
• Initial segment  cortex
COLLECTING DUCT
• Cuboidal lining
epithelium consist of :
– Principal (light) cell 
cuboidal, central nuclei,
light stain, possess a
single, nonmotile, apically
cilium (functions as a
mechanosensor that
monitors fluid flow)
– Intercalated cell  fewer, Intercalated cells  2 types:
stain more deeply, • Type A cells secrete H+ into the
scattered between tubular lumen
principal cells • Type B cells resorb H++ &
secrete HCO3-
EXTRARENAL PASSAGES
• All have similar structure (mucosa, muscularis, adventitia) except
urethra4
• Consist of :
1. Minor & major calyces
2. Renal pelvis  the expanded proximal end of the ureter & serves
to collect the urine excreted from the kidney & to transport it to
the ureter proper
3. Ureter  Epithelial lined muscular tubes designed to transport
urine from the kidneys to urinary bladder with aid of peristalsis
4. Urinary bladder:
• An epithelial-lined muscular viscus  has ability to distend &
accommodate up to 400 - 500 mL of urine without a change in
intraluminal pressure
• Able to initiate & sustain a contraction until the organ is empty
5. Urethra
Microscopic of Calyces, Renal Pelvis,
Ureters & Bladder
• The urinary bladder, ureter, & renal pelvis
have a similar anatomic composition:
– The innermost layer  transtitional epithelium
– A lamina propria
– Muscularis propria  smooth muscle
– Adventitia  fibroelastic tissue

• The anatomic landmarks used clinically &


pathologically to stage patients with urothelial
cancer in order to choose therapy & estimate
survival  It’s important to accurately identify
them microscopically
Pathologic staging of bladder cancer. This classification
follows the recommendations of the American Joint
Committee on Cancer (AJCC). In addition, prostatic stromal
invasion is considered stage pT4.
Urothelium
Urothelium
• The urinary bladder, ureters, & renal pelvis are lined by transitional
epithelium its histologic appearance transitional between
nonkeratinizing squamous & pseudostratified columnar

• Many histologists & pathologists suggested urothelium as a more


appropriate term

• The thickness of the urothelium vary according to the degree of


distension & anatomical location:
– The minor calyces: only 2- 3 cell layers
– In the contracted bladder: usually 6-7 cells thick
– In the ureter: 3-5 cells thick

• 3 regions:
– The superficial cells  in contact with the urinary space
– The intermediate cells
– The basal cells  lie on a basement membrane
Normal urothelium. The mucosa may be up to seven cells
thick in the bladder, but thickness will vary as a consequence
of distension and other factors. The superficial (umbrella)
cells have ample eosinophilic cytoplasm
Normal bladder is composed of urothelium, lamina propria
with mediumsized vessels, & thick muscle bundles of
muscularis propria.
URETER
Lamina Propria
Lamina Propria
• Lies between mucosal basement membrane &
muscularis propria

• Composed of dense connective tissue containing a


rich vascular network, lymphatic channels, sensory
nerve endings, & a few elastic fibers

• Wisps of smooth muscle commonly found in lamina


propria → not connected to the muscularis propria
Lamina propria. It is composed of
connective tissue, vascular structures,
sensory nerves, & elastic fibers. Notice
that the superficial connective tissue is
denser than the deep portion

Cross section of mid-ureter.


The elastic fibers & loose
connective tissue within the
lamina propria impart a
festooned appearance to the
urothelium. Notice that the
different layers of the
muscularis propria are
indiscernible
Delicate bundles of muscularis mucosae are associated with
mediumsized vessels in the midportion of the lamina propria
Urothelial wall along the minor calices. Thin layers of
lamina propria and muscularis propria are surrounded by
fat within the renal sinus
Muscularis Propria
Muscularis Propria
• Bladder:
– Composed of 3 smooth muscle coats, inner & outer longitudinal layers, & a central
circular layer  can only be identified consistently in the area of the bladder neck
– In other areas → have no definite orientation

• In the ureter: muscularis propria thicker distally & proximal


portion contains only two layers

• In the renal pelvis: muscularis propria becomes thinner along


the major & minor calyces, & no orientation of muscle fibers

• In the renal papillae → No muscular fibers between urothelium


& renal medulla
Full thickness section of the bladder.
A. Notice the irregular thickness of the lamina propria. The three layers
of muscle comprising the muscularis propria cannot be clearly defined.
In contradistinction to the muscularis propria of the gut, there are
ample amounts of soft tissue between muscle bundles in the bladder.
B. Cross section of distended bladder. The overall thickness of the viscus
is diminished as compared to the contracted bladder. Both the lamina
propria and muscularis propria become more compact
URETHRA
• Fibromuscular tube connecting bladder to external
urethral orifice

• Sexually dimorphic:
– Males → terminal duct for both urinary & genital
systems
– Females → urinary system only

• Lining – in both sexes grades from transitional


epithelium adjacent to bladder to stratified
squamous at orific
URETHRA
HISTOLOGY OF URETER, BLADDER & URETHRA
REFERENCES :
1. Color Textbook of Histologi, 6th edition, Gartner LP, Hiatt JL,
WB Saunders Company, Philadelphia, Pennsylvania, 2014. Pp
380-402
2. Junqueira's Basic Histology, Twelfth Edition. Anthony L.
Mescher, PhD. The McGraw-Hill Companies, 2010.
3. Essentials of Human Histology, 2nd Edition, William J. Krausse
PhD, Little Brown & Company (Inc), 1996
4. Histology For Pathologists, 4th Ed, Stacey E Mills, 2012